3. Atopic march and disease persistence
Not in all cases of childhood AE, the disease persists to adulthood. Risk factors for persistence are predicted by disease severity and serum CEGF levels at three years [4] as well as by early onset and high IL-13 levels [45] [46]. Furthermore, the risk to develop allergic rhinitis – especially in untreated AE - [46] or adult onset-asthma is significantly higher in patients with allergic diseases and AE [47]. Therefore, AE is claimed to be the first step of the so-called atopic march [48]. Underlying skin barrier defects in AE facilitate the penetration of allergens and irritants and can thereby lead to food allergy, allergic rhinitis and/or allergic asthma [13]. A signature of eight genes identifies multimorbidity for asthma, rhinitis, and dermatitis [49]. The fact that AE itself is a risk factor for the development of allergies also means that the treatment of this chronic inflammatory skin disease can be a prevention of other atopic diseases.